RN Utilization Review jobs in California

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Utilization Review Coordinator
Meritage Medical Network - Novato, CA
Utilization Review Coordinator:. Excellent full-time opportunity for an experienced UR Coordinator*....
Easily apply
Outside Care Clinic Reviewer RN
Profiling of non-plan providers, utilization patterns, direct interaction with providers to discuss, review and query services provided, charges and/or expenses...
RN, Utilization Management Compliance (El Segundo, CA)
Care management, utilization review or discharge planning experience. Performs reviews as needed on other related Care Management processes including...

Utilization Review Nurse

Mitchell International, Inc. - 2 reviews - California
Reviews requested treatment/procedures within Mitchell utilization review policies, URAC time frames or state-mandated timeframes (whichever is more restrictive...

Sr. Utilization Management RN

Alignment Healthcare - 3 reviews - Orange, CA
$100,000 a year
RN with clinical experience. Review referral denials for appropriate guidelines and language. Assist with UM queue calls relating to UM review and pre-service...
Easily apply

Regional Onsite Nurse Coordinator

Blue Shield of California - 226 reviews - Woodland Hills, CA 91367
Current CA RN License required; Develops treatment plans which promote, cost efficient health care services based on medical necessity in compliance with...

CM Spec RN

Kaiser Permanente - 3,527 reviews - Orange, CA  +1 location
Current California RN license required. Minimum two (2) years of clinical experience as an RN in an acute care or ambulatory care setting required....

Remote Case Manager - Case Management Resource Center

Adventist Health Southern California Network - Glendale, CA
Reviews the utilization of resources and works to reduce unnecessary lengths of stay and the over utilization of hospital services....

UM Nurse Consultant

Aetna - 1,573 reviews - Woodland Hills, CA  +1 location
Utilization Review and/or Managed Care experience preferred. Functional - Clinical / Medical/Concurrent review / discharge planning/1-3 Years....

Utilization Review Nurse - RN

Meritage Medical Network - Novato, CA 94949
Collaborates with concurrent review. Full-time position to join our Utilization Management Nursing Team. Prepares and presents cases for review with the Medical...
Easily apply

CM Cont Care Coord RN

Kaiser Permanente - 3,527 reviews - Pasadena, CA  +1 location
Current California RN license required. Trends utilization of health care resources. Minimum one (1) year of clinical experience as an RN in an acute care...

Medical Chart Review Nurse

MedPro Personnel - Woodland, CA
2+ years in acute care nursing and utilization review. Perform retrospective review of large hospital and physician claims for admission appropriateness, coding...
Easily apply

Medical Case Manager (Ambulatory RN)

CalOptima - 14 reviews - Orange, CA
Guidelines and regulations relevant to case management and utilization management. Identifies cases needing Supervisor, Manager, Director or Medical Director...
Regional Quality Manager - *Seeking Dialysis Experienced RN...
Conducts exit conferences with facility management staff to review risk assessment results and evaluation of QAI Program effectiveness....
Clinical Documentation Specialist - Full Time - Days
San Ramon Regional Medical Center - San Ramon, CA
Provide clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and utilization of acute care services....
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Company with RN Utilization Review jobs
HealthCare Partners is a top-rated southern-California medical group, recognized nationally for clinical excellence and patient satisfaction
Utilization Review Nurse salaries in California

$97,865 per year

29.2% higher than national average


Salary data based on 28 employees and 490 jobs